Medicare Advantage brings the best parts of Medicare coverage into one plan without having to worry as much about what is or isn’t covered.
The basic Medicare options come in parts:
- Part A: Hospital, hospice, home, and nursing facility care
- Part B: Preventative services, doctor’s appointments, outpatient care
- Part D: Helps with prescription drug costs
Medicare Advantage plans are considered Part C, combining Part A and Part B, with most plans extending to coverage of Part D.
This combination allows for more comprehensive coverage and less legwork checking what the individual parts cover.
What is a Medicare Advantage Plan Like in 2022?
Medicare Advantage plans fill in some of the gaps of much-needed health amenities that traditional Medicare lacks.
- Gym programs/fitness memberships
- Vision and hearing check-ups
- Dental coverage
Coverage in those areas is so important because dental, vision, and physical health can lead to or be connected to other health issues.
Gym Programs & Fitness Memberships
Advantage plans often offer services that focus on your overall wellness as well, including joining a gym or local fitness center. Not only do you have access to fitness programs, but you get to enjoy the social atmosphere that meeting others at a gym can offer.
Vision Check-Ups and Assistance
Even if you already have corrective lenses or contacts, age-related macular degeneration can change your prescription. Vision coverage is included, generally as an add-on, to Medicare Advantage. It can cover routine exams, glasses, prescription sunglasses, and contacts.
One-third of people between 65 and 74 are dealing with age-related hearing loss, and the tools needed to improve hearing can be unattainable under traditional Medicare plans for those on a limited income. Advantage plans often include a routine hearing exam and a discount or allowance for hearing aids.
Studies show oral health is an important contributor to your overall health and can help decrease serious health problems such as heart attack and stroke. Finding a plan that allows minor preventive services like a dental exam, cleanings, and x-rays plus minor comprehensive services for more serious needs helps prevent major dental work down the road.
Other Medicare Advantage Coverage Areas
If you need to be admitted to the hospital, your Advantage plan might provide post-hospital discharge meals delivered to your home. This can be a beneficial service to help get you the proper nutrition you need to get back on your feet while allowing you to focus on recuperating.
Those dealing with a chronic condition or disease will find more variables to improve their health care coverage and quality of life. Medicare Advantage allows members to join if they have a pre-existing condition.
Cost Control of Medicare Advantage Plans
As a staple of Medicare Advantage Plans, subscribers can better budget their health care costs because there is a cap on out-of-pocket spending for the year. All Medicare Part A and Part B services fall under this yearly limit. Even right out of the gate, you might be paying lower out-of-pocket costs than you were under Medicare Part A or Part B.
While most plans do include Part D prescription drug coverage, many also offer over-the-counter retail and mail-order allowance. These allowances help you purchase over-the-counter medicines, which can help when you’re on a fixed income.
Medicare Advantage Plan members aren’t eligible for Medigap, but it’s unnecessary with all the benefits of an Advantage Plan.
Another benefit is that some of the more expensive medical treatments, like chemotherapy and dialysis, are not allowed to cost more on a Medicare Advantage plan than a regular Medicare plan.
Types of Medicare Advantage Plans
Under the Medicare Advantage umbrella, there are several types of coverage.
- Health Maintenance Organization (HMO): Must use a specific provider network of doctors and providers.
- Preferred Provider Organization (PPO): Doctors and providers in the network will cost less than using out-of-network doctors and providers
- Private Fee-for-Service (PFFS): More expensive than the first two options, but set pricing and no referral or prior authorization requirements make it appealing.
- Special Needs Plan (SNP): Personalized coverage for those with specific health needs, like diabetes, dementia, or end-stage renal disease.
You’ll never get sticker shock with a Medicare Advantage plan, as you can check ahead of time to see if your medical treatment or doctor visit is permitted and how much it will cost you out of pocket.
Should you decide to take part in a clinical research study to help test new treatments or medications, you’ll get partial coverage for that as well.
Finding the Right Plan
Among all those plan options, there are requirements, limitations, and benefits. This isn’t a decision you should make spontaneously. Be sure you compare Medicare Advantage plans and ask questions to better understand what supplemental benefits and services you can get.
Enrollment only happens once a year, so don’t delay. Mark down the deadlines and set reminders.
The online plan finder tool at Medicare.gov can help you search for and compare Medicare Advantage plans available in your area.
Are Medicare Advantage Plans Worth It?
While customers always need to make the best decisions for their healthcare, it might be reassuring to know that 42% of the Medicare-receiving population choose a Medicare Advantage plan. That’s more than 26 million people enrolled, more than double the participants from a decade ago. 24% of Kansas Medicare customers choose Medicare Advantage.
The Congressional Budget Office crunched the numbers to find that Medicare Advantage plans will cross the majority threshold by 2030, with 51% of customers choosing that over other options.
We’re Here to Help
Blue Cross and Blue Shield of Kansas now offer Medicare Advantage in several areas across the state. We can also help you navigate plans if you are a snowbird and live somewhere else half the year.
To learn more about our Medicare Advantage plans and to see if it is available in your area, visit our website or call us at (866) 627-6705 to talk about your Medicare plan options.